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The same drug given before chemotherapy rather than after it. At one year, 65 percent of men on enzalutamide had no sign of the cancer growing on scans, against 14 percent on placebo, and the need for chemotherapy was pushed a long way back.
Tomasz Beer and the PREVAIL investigators randomised 1,717 chemotherapy-naive men with metastatic castration-resistant prostate cancer to 160 mg of enzalutamide daily or placebo, with radiographic progression-free survival and overall survival as co-primary endpoints. The study was stopped at a planned interim analysis after 540 deaths.
PREVAIL did for enzalutamide what COU-AA-302 did for abiraterone: it moved the drug in front of chemotherapy. The two results together are the reason a man diagnosed with castration-resistant disease today is far more likely to be offered a tablet than an infusion, and the reason the sequencing question (which tablet, then what) became the central practical problem of the disease.
The trial that made an androgen receptor inhibitor the usual first treatment for castration-resistant prostate cancer, and that delayed chemotherapy by a long margin for most men. Its effect sizes are why later trials in this setting are judged against a hazard ratio near 0.7 for survival.
One of the most cited trial reports Europe PMC returns for Abiraterone acetate in Prostate cancer, so it is a natural first reading for anyone weighing the idea it is linked from. The record was linked automatically by title and abstract; read the abstract above and the paper itself before relying on any figure.
An oral drug that works after chemotherapy has failed, in a disease where the previous option was more chemotherapy. Together with abiraterone it moved castration-resistant prostate cancer from a chemotherapy disease to a hormonal one, and set up the sequencing questions the field is still arguing about.
Shares Abiraterone in metastatic prostate cancer without previous chemotherapy, Johann de Bono, PSA (prostate-specific antigen), Castration-resistant prostate cancer (CRPC) and the tag prostate-evidence.
Shares Radiographic progression-free survival (rPFS), PSA (prostate-specific antigen), Enzalutamide, Castration-resistant prostate cancer (CRPC) and the tag prostate-evidence.
Shares PSA (prostate-specific antigen), Too many combinations to test, Enzalutamide, Castration-resistant prostate cancer (CRPC) and the tag prostate-evidence.
Shares Radiographic progression-free survival (rPFS), PSA (prostate-specific antigen), Enzalutamide, Castration-resistant prostate cancer (CRPC) and the tag prostate-evidence.
Shares AFFIRM: increased survival with enzalutamide in prostate cancer after chemotherapy, Enzalutamide, Castration-resistant prostate cancer (CRPC), Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch and the tag prostate-evidence.
Shares PSA (prostate-specific antigen), Castration-resistant prostate cancer (CRPC), Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch, Acquired resistance to every therapy and the tag prostate-evidence.
Shares AFFIRM: increased survival with enzalutamide in prostate cancer after chemotherapy, Johann de Bono, Castration-resistant prostate cancer (CRPC), Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch and the tag prostate-evidence.
Shares Karim Fizazi, Radiographic progression-free survival (rPFS), Enzalutamide, Prostate cancer roadmap: from Huggins and the discovery that a cancer can depend on a hormone, through the PSA epidemic and what it cost, the androgen receptor drugs, the DNA repair subset and PSMA, to a 2032 registry watch and the tag prostate-evidence.